RP Oil Credit Application

OVER 30 YEARS OF SERVICE

1111 Burns Street East, Unit #3
Whitby, Ontario L1N 6A6

Tel: (905) 666-2313
Fax: (905) 666-2761
Toll Free: 1-800-335-6623
www.rpoil.com

Credit Application (QMF13)

Customer Name

Invoicing:

Delivery:

Address

City

Postal

City

Postal

Phone

Fax

Phone

Fax

Purchasing Contact

Accounting Contact

Business Information:

Corporation Partnership

Name of Officers:

Name

Title

Name

Title

Premises:

Own Rent

Yrs. in Business

Supplier References:

Name

Address

City

Postal

City

Postal

Phone

Fax

Phone

Fax

Contact

Bank Information:

Name

Address

Phone

Fax:

Payment Terms:
(Select One)

By Invoice (Due 30 days from date of invoice
By Statement (Due 15th of the following month

CREDIT PRIVILEDGES WILL BE REVOKED IF ACCOUNT BECOMES PAST DUE

C.C. #

Exp.

I hereby authorize the firm or company to whom this application is submitted to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of a credit amount for any other direct business requirement.

Signature

Name

Date

Title

Approved

Date


I N D U S T R I A L & A U T O M O T I V E L U B R I C A N T S